Chronic Pain and Pilates

If you have been struggling with chronic pain, then you have surely heard from your doctor and others that one of the more effective ways of managing your pain is to engage in regular exercise.  Physical exercise produces many benefits for chronic pain sufferers including improved overall health, more pain tolerance, elevated mood and greater joint mobility.

However, not all exercise is the same.  While cardiovascular and strength training has some powerful benefits, they may also be damaging to some people with health conditions like arthritis or lower back pain. It is important to find a form of exercise that minimizes health risks while producing the most benefits.

Among the most popular exercise programs for chronic pain patients is Pilates which combines strength training with endurance and flexibility exercises. This low-impact exercise program focuses on strengthening core muscles as well as improving posture and flexibility. A typical session is about an hour long.

Pilates has proven beneficial for many chronic pain conditions, including

  • Chronic back pain
  • Neck pain
  • Hip pain
  • Shoulder pain
  • Arthritis
  • Fibromyalgia
  • Multiple Sclerosis

A Short Introduction to Pilates

Originally developed in the 1920’s by George Pilates, the Pilates exercise program was initially designed to help wounded soldiers recuperate.  George Pilates drew on his knowledge of yoga, tai chi, and martial arts as well as war-time training as a nurse to develop his system. His philosophy was that physical health could only be improved along with mental health. 

Instead of bulking up muscles, Pilates prioritizes lean musculature, flexibility and core strength.  Similar to yoga, Pilates utilizes an array of exercises that are precisely performed to improve the strength of core muscles in the abdomen, back, butt, obliques and thighs. It also emphasizes balance and coordination, making it highly beneficial for chronic pain patients.

Unlike many other exercise systems that require repetition of a simple movement, Pilates emphasizes complex, coordinated motions that involve the entire body. This not only produces physical improvement across a wide range of body parts, but it also requires practitioners to maintain intense mental concentration.

If you are trying to maximize your workout while minimizing potential injury, Pilates is ideal. One of the major causes of orthopedic injury is muscle imbalance, i.e. when one muscle group is much stronger than others. Because Pilates is an entire body workout, muscle imbalance is rarely an issue.

Pilates Basics

There are two major classes of Pilates programs: spring-loaded or body weight resistance. Beginner classes often involve only body weight resistance and are easily performed with just a mat.  Introductory classes focus on breathing in an effort to make participants more aware of the diaphragm and core muscle groups. For example a beginner class may only perform types of sit-ups and planks, until members are ready for more involved exercises like leg lifts or bridges.

In more advanced Pilates classes, which tend to be smaller or one-on-one, more complex equipment is used. Spring-loaded equipment allows members to improve arm and leg strength while still maintaining a constant focus on core muscles. 

The Benefits of Pilates for Chronic Pain Patients

There are many reasons why you should consider a Pilates program if you suffer from a chronic pain condition like lower back pain or joint pain.

  • Pain mitigation—almost any exercise will help diminish your pain to some degree because physical activity boosts production of natural pain killers called endorphins. Endorphins interact with your brain in the same way that opioids do, by attaching to opiate receptors which block pain impulses. However, Pilates produces a larger boost because it works muscles across your entire body.
  • Elevates mood—chronic pain often produces secondary emotional conditions like stress and depression that worsen pain symptoms.  Endorphins produced during physical exercise also provide stress relief and enhanced mood.
  • Muscle relaxation—another common condition among chronic pain sufferers is muscle tension.  This muscle contraction can be so intense that it produces pain symptoms of its own. Pilates helps counteract this by stretching these tense muscles, allowing blood to flow. Working these muscles in a positive manner also heats the surrounding tissue and relaxes the muscles.
  • Joint mobility—by strengthening the muscles around joints, you provide more torque on bones.  This provides a greater range of motion and produces more mobility. This improved mobility also has many secondary benefits including more confidence and greater independence.
  • Improved posture—much of Pilates involves correct positioning of your body which gives you more awareness of your posture.  Furthermore, as you strengthen your core muscle groups, your posture should naturally improve as well.
  • Lose weight—obesity is often a health complication for chronic pain. Excess weight can worsen many pain conditions, but fatty tissue has also been shown to make you more sensitive to pain.  Pilates is a proven calorie burner that employs a wide array of muscle groups in an aerobic manner. Also, the whole body workout produces caloric dividends throughout the day as you practice controlled breathing and enhanced circulation.
  • Low impact—almost all Pilates exercises are performed while sitting or lying on the floor which means there is minimal impact on your joints. You can enjoy all of the cardiovascular and strengthening benefits of other exercise programs with almost none of the wear and tear that those programs entail.
  • Flexible training—Pilates is structured to allow you to proceed at your own pace.  If you feel that you need more time developing your core, you can focus on your current exercises.  However, if you think that you can handle more, there is always a way to make your program more challenging.

If you think that Pilates is the right exercise program to help manage your chronic pain, you should first consult with your physician.  He or she can use knowledge about your current health to recommend a Pilates program that can help with your chronic pain condition without exposing you to further injury.  If you start a Pilates class, you may also wish to discuss your condition with the instructor to see if they have any recommendations.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care